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Persistent pulmonary hypertension neonate

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https://www.readbyqxmd.com/read/29331003/oral-sildenafil-use-in-neonates-with-persistent-pulmonary-hypertension-of-newborn
#1
Ali Shabbir Hussain, Rehan Ali, Shakeel Ahmed, Farah Naz, Anila Haroon
BACKGROUND: The prevalence of PPHN has been estimated at 1.9 per 1000 live births. After the discovery of iNO's, its efficacy and benefit in PPHN is well established. Even in the best of centers equipped with iNo and ECMO the mortality is around 20%. Also, iNO is expensive and difficult to administer and monitor which makes it difficult choice in our part of the world. Furthermore About 40% of patients do not respond or have rebound pulmonary hypertension after discontinuation. Owing to these reasons, other treatment modalities like phosphodiesterase inhibitors such as Sildenafil need to be evaluated...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29316539/cyanosis-and-stroke-due-to-functional-cor-triatriatum-dexter-in-a-neonate
#2
Rachel L León, Nicholas B Zaban, Marcus S Schamberger, Chang Y Ho, Ulrike Mietzsch
Small remnants of the right valve of the sinus venosus are commonly found in adults, but the incidence and risk associated with these embryonic remnants in neonates are not well studied. The following report describes a cyanotic neonate with a large Eustachian valve remnant creating a functional cor triatriatum dexter who was initially diagnosed with persistent pulmonary hypertension of the newborn. The cyanosis in this infant improved over the first postnatal week with conservative management, but she suffered multifocal subcortical stroke, likely related to her intracardiac shunt...
January 10, 2018: Neonatology
https://www.readbyqxmd.com/read/29302380/a-case-of-fatal-pulmonary-hypoplasia-with-congenital-diaphragmatic-hernia-thoracic-myelomeningocele-and-thoracic-dysplasia
#3
Ai Ito, Hideshi Fujinaga, Sachiko Matsui, Kumiko Tago, Yuka Iwasaki, Shuhei Fujino, Junko Nagasawa, Shoichiro Amari, Masao Kaneshige, Yuka Wada, Shigehiro Takahashi, Keiko Tsukamoto, Osamu Miyazaki, Takako Yoshioka, Akira Ishiguro, Yushi Ito
Background  Congenital diaphragmatic hernia (CDH) is fatal in severe cases of pulmonary hypoplasia. We experienced a fatal case of pulmonary hypoplasia due to CDH, thoracic myelomeningocele (MMC), and thoracic dysplasia. This constellation of anomalies has not been previously reported. Case Report  A male infant with a prenatal diagnosis of thoracic MMC with severe hydrocephalus and scoliosis was born at 36 weeks of gestation. CDH was found after birth and the patient died of respiratory failure due to pulmonary hypoplasia and persistent pulmonary hypertension of the newborn at 30 hours of age despite neonatal intensive care...
October 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29298856/persistent-pulmonary-hypertension-of-the-newborn-in-extremely-preterm-infants-a-japanese-cohort-study
#4
Hidehiko Nakanishi, Hideyo Suenaga, Atsushi Uchiyama, Satoshi Kusuda
OBJECTIVE: To investigate the characteristics of persistent pulmonary hypertension of the newborn (PPHN) in extremely preterm infants and its impact on neurodevelopmental outcomes at 3 years of age. DESIGN: A retrospective multicentre cohort study. SETTINGS: 202 tertiary perinatal centres registered in the Neonatal Research Network of Japan (NRNJ). PATIENTS: Infants born at <28 weeks of gestational age (GA), between 2003 and 2012, were extracted from tertiary perinatal centres participating in NRNJ...
January 3, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29251627/pbx-transcription-factors-drive-pulmonary-vascular-adaptation-to-birth
#5
David J McCulley, Mark D Wienhold, Elizabeth A Hines, Timothy A Hacker, Allison Rogers, Ryan J Pewowaruk, Rediet Zewdu, Naomi C Chesler, Licia Selleri, Xin Sun
A critical event in the adaptation to extrauterine life is relaxation of the pulmonary vasculature at birth, allowing for a rapid increase in pulmonary blood flow that is essential for efficient gas exchange. Failure of this transition leads to pulmonary hypertension (PH), a major cause of newborn mortality associated with preterm birth, infection, hypoxia, and malformations including congenital diaphragmatic hernia (CDH). While individual vasoconstrictor and dilator genes have been identified, the coordination of their expression is not well understood...
December 18, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29223466/long-term-pulmonary-and-cardiovascular-morbidities-of-neonatal-hyperoxia-exposure-in-mice
#6
Renuka T Menon, Amrit Kumar Shrestha, Corey L Reynolds, Roberto Barrios, Binoy Shivanna
Pulmonary hypertension (PH) frequently occurs in infants with bronchopulmonary dysplasia (BPD), causing increased mortality and right ventricular (RV) dysfunction that persists into adulthood. A first step in developing better therapeutic options is identifying and characterizing an appropriate animal model. Previously, we characterized the short-term morbidities of a model in which C57BL/6J wild-type (WT) mice were exposed to 70% O2 (hyperoxia) during the neonatal period. Here, we aimed to determine the long-term morbidities using lung morphometry, echocardiography (Echo), and cardiac magnetic resonance imaging (cMRI)...
December 7, 2017: International Journal of Biochemistry & Cell Biology
https://www.readbyqxmd.com/read/29204652/effect-of-nasal-continuous-positive-airway-pressure-on-infants-with-meconium-aspiration-syndrome-a-randomized-clinical-trial
#7
Aakash Pandita, Srinivas Murki, Tejo Pratap Oleti, Baswaraj Tandur, Sai Kiran, Sachin Narkhede, Amrut Prajapati
Importance: Nasal continuous positive airway pressure (NCPAP) as a primary respiratory therapy in meconium aspiration syndrome (MAS) has not been studied extensively. Nasal continuous positive airway pressure, when applied in newborns with MAS, may resolve atelectasis by sufficiently expanding partially obstructed small airways and stabilizing the collapsing terminal airways to enhance oxygen exchange. Objective: To compare NCPAP vs standard care in neonates with moderate to severe respiratory failure due to MAS in reducing the need for invasive ventilation...
December 4, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/29193315/review-shows-that-implementing-a-nationwide-protocol-for-congenital-diaphragmatic-hernia-was-a-key-factor-in-reducing-mortality-and-morbidity
#8
REVIEW
L Storme, J Boubnova, S Mur, L Pognon, D Sharma, E Aubry, R Sfeir, P Vaast, T Rakza, A Benachi
The French Rare Disease Reference Center for Congenital Diaphragmatic Hernia (CDH) was created in 2008, to implement a national protocol for fetuses and children with this serious condition. Neonatal mortality from CDH is 30-40%, mainly due to pulmonary hypoplasia and persistent pulmonary hypertension, and half of those who live have high respiratory, nutritional and digestive morbidity. CDH management requires long-term and specialised multidisciplinary care. It has been well established that a standardised management protocol improves the prognosis of children with CDH...
November 28, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29127236/structural-and-functional-changes-of-the-pulmonary-vasculature-after-hypoxia-exposure-in-the-neonatal-period-a-new-swine-model-of-pulmonary-vascular-disease
#9
Daphne P M de Wijs-Meijler, Richard W B van Duin, Dirk J Duncker, Urs Scherrer, Claudio Sartori, Irwin K M Reiss, Daphne Merkus
Pulmonary vascular disease (PVD) represents an underestimated and increasing clinical burden in the neonatal period, but also later in life, when exercise-tolerance is decreased. Animal models performing long-term follow-up after a perinatal insult are lacking. This study aimed to develop and characterize a neonatal swine model with hypoxia-induced PVD, during long-term follow-up after re-exposure to normoxia, and to investigate the exercise response in this model. Piglets were exposed to a normoxic (N=10) or hypoxic environment (N=9) for four weeks...
November 10, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29126435/human-amnion-cells-reverse-acute-and-chronic-pulmonary-damage-in-experimental-neonatal-lung-injury
#10
Dandan Zhu, Jean Tan, Amina S Maleken, Ruth Muljadi, Siow T Chan, Sin N Lau, Kirstin Elgass, Bryan Leaw, Joanne Mockler, Daniel Chambers, Kristen T Leeman, Carla F Kim, Euan M Wallace, Rebecca Lim
BACKGROUND: Despite advances in neonatal care, bronchopulmonary dysplasia (BPD) remains a significant contributor to infant mortality and morbidity. While human amnion epithelial cells (hAECs) have shown promise in small and large animal models of BPD, there is scarce information on long-term benefit and clinically relevant questions surrounding administration strategy remain unanswered. In assessing the therapeutic potential of hAECs, we investigated the impact of cell dosage, administration routes and timing of treatment in a pre-clinical model of BPD...
November 10, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/29108501/occult-massive-visceral-fat-necrosis-following-therapeutic-hypothermia-for-neonatal-encephalopathy
#11
Salwa Khedr, Anna Piskorski, Adrienne R Bingham, Justin Goldstein, Abbot R Laptook, Monique E De Paepe
Therapeutic hypothermia (head or whole-body cooling) improves survival and neurodevelopmental outcome in term newborns with moderate-to-severe encephalopathy. Hypothermia treatment is well tolerated; the most common side effect is thrombocytopenia. In about 1% of infants, focal subcutaneous fat necrosis has been reported. We describe a case of clinically unsuspected massive visceral fat necrosis in a term infant with Apgar score 0 at 1 min ("resuscitated apparently stillborn" infant) who was treated with therapeutic hypothermia for 72 h and expired on the 25th day of life following a neonatal course complicated by severe encephalopathy, pulmonary artery hypertension, persistent thrombocytopenia, hypoglycemia, and severe basal ganglia-thalamic abnormalities on magnetic resonance imaging...
January 1, 2017: Pediatric and Developmental Pathology
https://www.readbyqxmd.com/read/29058384/nitric-oxide-for-the-treatment-of-preterm-infants-with-severe-rds-and-pulmonary-hypertension
#12
Carlo Dani, Iuri Corsini, Jessica Cangemi, Venturella Vangi, Simone Pratesi
BACKGROUND: Inhaled nitric oxide (iNO) cannot be recommended for the routine treatment of respiratory failure in premature neonates, but it has been suggested that the effectiveness of iNO therapy should be further studied in more select preterm infants, such as those with persistent pulmonary hypertension of the newborn (PPHN). OBJECTIVE: To evaluate the frequency of PPHN in very preterm infants with severe respiratory distress syndrome (RDS), to assess the effectiveness of iNO in these patients, and to individuate possible predictive factors for the response to iNO in preterm infants with RDS...
November 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29058246/factors-relating-caesarean-section-to-persistent-pulmonary-hypertension-of-the-newborn
#13
REVIEW
Niralee Babooa, Wen-Jing Shi, Chao Chen
BACKGROUND: Several studies have clearly demonstrated a significantly higher incidence of persistent pulmonary hypertension of the newborn (PPHN) in neonates delivered by caesarean section (CS) compared to those delivered vaginally. The pathophysiological factors underlying the link between CS and PPHN are still poorly understood. In this review, we describe the mechanisms that could explain the association between CS delivery and subsequent PPHN, as well as potential preventive measures...
December 2017: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/29047087/effects-of-hyperoxia-on-the-developing-airway-and-pulmonary-vasculature
#14
Christina M Pabelick, Michael A Thompson, Rodney D Britt
Although it is necessary and part of standard practice, supplemental oxygen (40-90% O2) or hyperoxia is a significant contributing factor to development of bronchopulmonary dysplasia, persistent pulmonary hypertension, recurrent wheezing, and asthma in preterm infants. This chapter discusses hyperoxia and the role of redox signaling in the context of neonatal lung growth and disease. Here, we discuss how hyperoxia promotes dysfunction in the airway and the known redox-mediated mechanisms that are important for postnatal vascular and alveolar development...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29046161/inhaled-nitric-oxide-in-preterm-neonates-with-refractory-hypoxemia-associated-to-oligohydramnios
#15
Alvarado Socarras Jorge, Castro M Javier, Fredi Alexander Diaz-Quijano
BACKGROUND: Therapy with inhaled nitric oxide (iNO) is effective in the management of pulmonary hypertension and severe hypoxemia. However, these benefits have not been demonstrated in preterm infants (<34 weeks). The objective of this report is to present the experience of eight cases of preterm neonates with respiratory distress syndrome (RDS) and refractory hypoxemia, with oligohydramnios history. METHODS: We evaluated the clinical feature of 8 preterm neonates with severe hypoxemia who had maternal antecedents of oligoamnios, mainly due to premature rupture of membranes...
October 17, 2017: Current Drug Discovery Technologies
https://www.readbyqxmd.com/read/29033108/clinical-course-in-infants-diagnosed-with-transient-tachypnea-of-newborn-a-clinical-trial-assessing-the-role-of-conservative-versus-conventional-management
#16
M Dehdashtian, M Aletayeb, A Malakian, M R Aramesh, H Malvandi
BACKGROUND: Transient tachypnea of the newborn (TTN) is a respiratory disorder secondary to inadequate or delayed clearance of lung fluids. Early symptoms of the disease are indistinguishable from neonatal respiratory distress syndrome, pneumonia, and persistent pulmonary hypertension. Therefore, these newborns, in addition to receiving conservative management, receive antibiotics until blood cultures provide definite results. In this study, we assessed the clinical course of neonates diagnosed with TTN who received conventional versus conservative management...
October 9, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29017182/factors-and-outcomes-of-persistent-pulmonary-hypertension-of-the-newborn-associated-with-acute-kidney-injury-in-thai-neonates
#17
Wuttichart Kamolvisit, Sutthikiat Jaroensri, Benthira Ratchatapantanakorn, Narongsak Nakwan
No abstract text is available yet for this article.
October 10, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28974647/a-quality-improvement-project-to-improve-evidence-based-inhaled-nitric-oxide-use
#18
Colleen A Hughes Driscoll, Natalie L Davis, Megan Miles, Dina El-Metwally
BACKGROUND: Inhaled nitric oxide (INO) reduces extracorporeal membrane oxygenation (ECMO) use in term and near-term neonates with persistent pulmonary hypertension of the newborn; however, its overutilization is increasing. We hypothesized that implementing a shared baseline protocol would safely improve evidence-based INO use in a Level IV neonatal ICU. METHODS: Through several plan-do-study-act cycles, a shared baseline protocol for initiation and weaning of INO was developed and implemented starting in August 2014...
October 3, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28926832/persistent-pulmonary-hypertension-of-the-newborn-in-twin-twin-transfusion-syndrome-a-case-control-study
#19
Manon Gijtenbeek, M C Haak, Derk Jan Ten Harkel, Arjan B Te Pas, Johanna M Middeldorp, Frans J C M Klumper, Nan van Geloven, Dick Oepkes, Enrico Lopriore
BACKGROUND: Persistent pulmonary hypertension of the newborn (PPHN) is associated with severe morbidity and mortality. Twin-twin transfusion syndrome (TTTS) is suggested to increase the risk of PPHN. OBJECTIVES: To describe the incidence of PPHN in TTTS twins and to identify risk factors in TTTS twins for the development of severe PPHN. METHODS: Cases with severe PPHN were extracted from our monochorionic twin database (2002-2016). Severe PPHN was defined as severe hypoxaemia requiring mechanical ventilation and inhaled nitric oxide (iNO) treatment, confirmed by strict echocardiographic criteria...
2017: Neonatology
https://www.readbyqxmd.com/read/28923474/beyond-the-inhaled-nitric-oxide-in-persistent-pulmonary-hypertension-of-the-newborn
#20
REVIEW
Mei-Yin Lai, Shih-Ming Chu, Satyan Lakshminrusimha, Hung-Chih Lin
Persistent pulmonary hypertension (PPHN) is a consequence of failed pulmonary vascular transition at birth and leads to pulmonary hypertension with shunting of deoxygenated blood across the ductus arteriosus (DA) and foramen ovale (FO) resulting in severe hypoxemia, and it may eventually lead to life-threatening circulatory failure. PPHN is a serious event affecting both term and preterm infants in the neonatal intensive care unit. It is often associated with diseases such as congenital diaphragmatic hernia, meconium aspiration, sepsis, congenital pneumonia, birth asphyxia and respiratory distress syndrome...
August 10, 2017: Pediatrics and Neonatology
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